Provider Demographics
NPI:1538233200
Name:KHAN, MUHAMMAD FAISAL (MD)
Entity type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:FAISAL
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2743 IMPERIA DR STE 101
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-8988
Mailing Address - Country:US
Mailing Address - Phone:281-494-6387
Mailing Address - Fax:
Practice Address - Street 1:2743 IMPERIA DR STE 101
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-8988
Practice Address - Country:US
Practice Address - Phone:281-494-6387
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE237452084N0400X
TXN01622084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX202188303Medicaid
TXP01023356OtherMEDICARE RR
TXP00856366OtherMEDICARE RAILROAD
TX8DY924OtherBLUE CROSS BLUE SHIELD
TX1538233200OtherBLUE CROSS BLUE SHIELD
TX202188302Medicaid
TXP00856366OtherMEDICARE RAILROAD
TX8L9983Medicare PIN
TX202188303Medicaid
TXTXB135469Medicare PIN